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Gracitelli and coauthors investigated whether there were racial differences in visual field variability over time. In a multicenter, prospective observational cohort study, the authors noted that individuals of African descent with glaucoma showed a larger variability in standard automated perimetry results and increased times to detect progression on computer-simulated analyses compared with individuals of European descent. The findings suggest that increased visual field variability in glaucomatous eyes in individuals of African descent may result in delayed detection of progression that could potentially contribute to explain higher rates of glaucoma-associated visual impairment in this population.
Continuing Medical Education
Scott and coauthors report secondary outcomes of monthly vs treat-and-extend regimens for patients who respond well to an initial 6 monthly anti–vascular endothelial growth factor injections for macular edema from a retinal vein occlusion. Meaningful visual acuity differences at 12 months were not present in comparisons of participants who had received a treat-and-extend regimen vs patients who received monthly injections between months 6 and 12. However, because of the wide confidence intervals on visual acuity differences between the monthly and the treat-and-extend groups, caution is warranted before concluding that the 2 regimens are associated with similar vision outcomes.
Author Audio Interview
Understanding supportive care needs in patients with cancer is important for developing approaches that enhance quality of life and promote satisfaction with care. Williamson and coauthors characterize the needs of patients with uveal melanoma and what sociodemographic, medical, and psychosocial factors assessed before cancer diagnosis are associated with unmet need severity after diagnosis among this patient group. Their survey study demonstrated that nearly all patients endorsed at least 1 unmet need at 1 week after diagnosis. Although need severity decreased within 3 months, most patients continued to report important unmet needs. Neuroticism, instrumental social support, and social network size as assessed before diagnosis were associated with unmet need severity more than sociodemographic and medical characteristics. Their results suggest social support and neuroticism before diagnosis could be assessed to identify patients for proactive supportive intervention.
Coker and coauthors investigate what proportion of adults with irreversible vision impairment are referred to low-vision rehabilitation services by ophthalmology residents and attending ophthalmologists working in a publicly funded eye clinic that primarily serves uninsured persons. In their cross-sectional study of 143 patients with irreversible vision impairment in 1 or both eyes, referral for low-vision rehabilitation services was low for patients with irreversible bilateral (11%) and unilateral (2%) vision impairment, as noted in the electronic health record. Their findings highlight the need for improved education of ophthalmologists and residents in ophthalmology about referral to rehabilitation services for patients with low vision.
Highlights. JAMA Ophthalmol. 2018;136(4):311. doi:10.1001/jamaophthalmol.2017.3718
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